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Prevalence and Impact of Renal Insufficiency on Clinical Outcomes of Patients Undergoing Coronary Revascularization
Background Patients with renal insufficiency are more likely to die after coronary revascularization, but mild renal insufficiency is neglected and little is known about its clinical effects. Methods and Results In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) wer...
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| Published in: | Circulation Journal 2007, Vol.71(8), pp.1299-1304 |
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| container_title | Circulation Journal |
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| creator | Zhang, Qiang Ma, Chang-Sheng Nie, Shao-Ping Du, Xin Lv, Qiang Kang, Jun-Ping Zhang, Yin Hu, Rong Jia, Chang-Qi Liu, Xin-Min Liu, Xiao-Hui Dong, Jian-Zeng Chen, Fang Zhou, Yu-Jie Lv, Shu-Zheng Huang, Fang-Jiong Gu, Cheng-Xiong Wu, Xue-Si |
| description | Background Patients with renal insufficiency are more likely to die after coronary revascularization, but mild renal insufficiency is neglected and little is known about its clinical effects. Methods and Results In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) were analyzed to evaluate the association between CrCl and clinical outcome. The mean serum creatinine was 1.0±0.4 mg/dl, with 4.3% above normal; in 65.8% CrCl was |
| doi_str_mv | 10.1253/circj.71.1299 |
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Methods and Results In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) were analyzed to evaluate the association between CrCl and clinical outcome. The mean serum creatinine was 1.0±0.4 mg/dl, with 4.3% above normal; in 65.8% CrCl was <90 ml/min. During hospitalization, there were significant differences in mortality among the groups stratified by CrCl (p<0.0001). During follow-up after hospital discharge, there were significant differences in mortality (p<0.0001), new-onset myocardial infarction (p=0.007), and stroke (p=0.032). In patients with severe renal insufficiency, the in-hospital and follow-up mortality reached 15.4% and 31.3%, respectively. The independent risk factors for all-cause death after revascularization were the mode of revascularization, age and the CrCl level. In patients with mild renal insufficiency or normal renal function, the all-cause mortality after percutaneous coronary intervention was significantly lower than that after CABG. Conclusions Renal insufficiency is not rare in patients undergoing coronary revascularization and in the present study even mild renal insufficiency correlated with adverse clinical outcomes after revascularization. In patients with normal renal function or mild renal insufficiency, the mode of revascularization might lead to a prognostic difference. (Circ J 2007; 71: 1299 - 1304)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.71.1299</identifier><identifier>PMID: 17652899</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Adult ; Aged ; Chronic kidney disease ; Creatine ; Creatinine clearance ; End-stage renal disease ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Mortality ; Myocardial Infarction - etiology ; Myocardial Revascularization - adverse effects ; Myocardial Revascularization - mortality ; Prevalence ; Prognosis ; Renal Insufficiency - complications ; Renal Insufficiency - mortality ; Revascularization ; Stroke - etiology ; Treatment Outcome</subject><ispartof>Circulation Journal, 2007, Vol.71(8), pp.1299-1304</ispartof><rights>2007 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c580t-2f8baaad18997a69ef3584ea0e1a0d63e8ed604b7169913ff718a9bc8039f1c13</citedby><cites>FETCH-LOGICAL-c580t-2f8baaad18997a69ef3584ea0e1a0d63e8ed604b7169913ff718a9bc8039f1c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17652899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Qiang</creatorcontrib><creatorcontrib>Ma, Chang-Sheng</creatorcontrib><creatorcontrib>Nie, Shao-Ping</creatorcontrib><creatorcontrib>Du, Xin</creatorcontrib><creatorcontrib>Lv, Qiang</creatorcontrib><creatorcontrib>Kang, Jun-Ping</creatorcontrib><creatorcontrib>Zhang, Yin</creatorcontrib><creatorcontrib>Hu, Rong</creatorcontrib><creatorcontrib>Jia, Chang-Qi</creatorcontrib><creatorcontrib>Liu, Xin-Min</creatorcontrib><creatorcontrib>Liu, Xiao-Hui</creatorcontrib><creatorcontrib>Dong, Jian-Zeng</creatorcontrib><creatorcontrib>Chen, Fang</creatorcontrib><creatorcontrib>Zhou, Yu-Jie</creatorcontrib><creatorcontrib>Lv, Shu-Zheng</creatorcontrib><creatorcontrib>Huang, Fang-Jiong</creatorcontrib><creatorcontrib>Gu, Cheng-Xiong</creatorcontrib><creatorcontrib>Wu, Xue-Si</creatorcontrib><title>Prevalence and Impact of Renal Insufficiency on Clinical Outcomes of Patients Undergoing Coronary Revascularization</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background Patients with renal insufficiency are more likely to die after coronary revascularization, but mild renal insufficiency is neglected and little is known about its clinical effects. Methods and Results In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) were analyzed to evaluate the association between CrCl and clinical outcome. The mean serum creatinine was 1.0±0.4 mg/dl, with 4.3% above normal; in 65.8% CrCl was <90 ml/min. During hospitalization, there were significant differences in mortality among the groups stratified by CrCl (p<0.0001). During follow-up after hospital discharge, there were significant differences in mortality (p<0.0001), new-onset myocardial infarction (p=0.007), and stroke (p=0.032). In patients with severe renal insufficiency, the in-hospital and follow-up mortality reached 15.4% and 31.3%, respectively. The independent risk factors for all-cause death after revascularization were the mode of revascularization, age and the CrCl level. In patients with mild renal insufficiency or normal renal function, the all-cause mortality after percutaneous coronary intervention was significantly lower than that after CABG. Conclusions Renal insufficiency is not rare in patients undergoing coronary revascularization and in the present study even mild renal insufficiency correlated with adverse clinical outcomes after revascularization. In patients with normal renal function or mild renal insufficiency, the mode of revascularization might lead to a prognostic difference. (Circ J 2007; 71: 1299 - 1304)</description><subject>Adult</subject><subject>Aged</subject><subject>Chronic kidney disease</subject><subject>Creatine</subject><subject>Creatinine clearance</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Revascularization - adverse effects</subject><subject>Myocardial Revascularization - mortality</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Renal Insufficiency - complications</subject><subject>Renal Insufficiency - mortality</subject><subject>Revascularization</subject><subject>Stroke - etiology</subject><subject>Treatment Outcome</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNpF0Etr3DAUBWBRGppHu8y2aNWdE8myLWmZDG0zEEgozVrcka8mGmxpKtmB5NdXkxkyGz24H4fLIeSSsytet-La-mQ3V5KXn9afyBkXjawaVbPP7--u0qoRp-Q85w1jtWat_kJOuezaWml9RvJjwhcYMFikEHq6HLdgJxod_YMBBroMeXbOW1_EK42BLgYfvC2Th3myccS8s48wFTBl-hR6TOvow5ouYooB0msJeoFs5wGSfysuhq_kxMGQ8dvhviBPv37-XdxV9w-_l4ub-8q2ik1V7dQKAHpeFpXQaXSiVQ0CQw6s7wQq7DvWrCTvtObCOckV6JVVTGjHLRcX5Mc-d5vivxnzZEafLQ4DBIxzNpJJIUXdFVjtoU0x54TObJMfy-6GM7Nr2by3bCQ3u5aL_34Inlcj9kd9qLWA2z3Y5AnW-AEgTd4OeIxT-2OXehw-QzIYxH87D5Ns</recordid><startdate>2007</startdate><enddate>2007</enddate><creator>Zhang, Qiang</creator><creator>Ma, Chang-Sheng</creator><creator>Nie, Shao-Ping</creator><creator>Du, Xin</creator><creator>Lv, Qiang</creator><creator>Kang, Jun-Ping</creator><creator>Zhang, Yin</creator><creator>Hu, Rong</creator><creator>Jia, Chang-Qi</creator><creator>Liu, Xin-Min</creator><creator>Liu, Xiao-Hui</creator><creator>Dong, Jian-Zeng</creator><creator>Chen, Fang</creator><creator>Zhou, Yu-Jie</creator><creator>Lv, Shu-Zheng</creator><creator>Huang, Fang-Jiong</creator><creator>Gu, Cheng-Xiong</creator><creator>Wu, Xue-Si</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2007</creationdate><title>Prevalence and Impact of Renal Insufficiency on Clinical Outcomes of Patients Undergoing Coronary Revascularization</title><author>Zhang, Qiang ; Ma, Chang-Sheng ; Nie, Shao-Ping ; Du, Xin ; Lv, Qiang ; Kang, Jun-Ping ; Zhang, Yin ; Hu, Rong ; Jia, Chang-Qi ; Liu, Xin-Min ; Liu, Xiao-Hui ; Dong, Jian-Zeng ; Chen, Fang ; Zhou, Yu-Jie ; Lv, Shu-Zheng ; Huang, Fang-Jiong ; Gu, Cheng-Xiong ; Wu, Xue-Si</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c580t-2f8baaad18997a69ef3584ea0e1a0d63e8ed604b7169913ff718a9bc8039f1c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Chronic kidney disease</topic><topic>Creatine</topic><topic>Creatinine clearance</topic><topic>End-stage renal disease</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Revascularization - adverse effects</topic><topic>Myocardial Revascularization - mortality</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Renal Insufficiency - complications</topic><topic>Renal Insufficiency - mortality</topic><topic>Revascularization</topic><topic>Stroke - etiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Qiang</creatorcontrib><creatorcontrib>Ma, Chang-Sheng</creatorcontrib><creatorcontrib>Nie, Shao-Ping</creatorcontrib><creatorcontrib>Du, Xin</creatorcontrib><creatorcontrib>Lv, Qiang</creatorcontrib><creatorcontrib>Kang, Jun-Ping</creatorcontrib><creatorcontrib>Zhang, Yin</creatorcontrib><creatorcontrib>Hu, Rong</creatorcontrib><creatorcontrib>Jia, Chang-Qi</creatorcontrib><creatorcontrib>Liu, Xin-Min</creatorcontrib><creatorcontrib>Liu, Xiao-Hui</creatorcontrib><creatorcontrib>Dong, Jian-Zeng</creatorcontrib><creatorcontrib>Chen, Fang</creatorcontrib><creatorcontrib>Zhou, Yu-Jie</creatorcontrib><creatorcontrib>Lv, Shu-Zheng</creatorcontrib><creatorcontrib>Huang, Fang-Jiong</creatorcontrib><creatorcontrib>Gu, Cheng-Xiong</creatorcontrib><creatorcontrib>Wu, Xue-Si</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Qiang</au><au>Ma, Chang-Sheng</au><au>Nie, Shao-Ping</au><au>Du, Xin</au><au>Lv, Qiang</au><au>Kang, Jun-Ping</au><au>Zhang, Yin</au><au>Hu, Rong</au><au>Jia, Chang-Qi</au><au>Liu, Xin-Min</au><au>Liu, Xiao-Hui</au><au>Dong, Jian-Zeng</au><au>Chen, Fang</au><au>Zhou, Yu-Jie</au><au>Lv, Shu-Zheng</au><au>Huang, Fang-Jiong</au><au>Gu, Cheng-Xiong</au><au>Wu, Xue-Si</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Impact of Renal Insufficiency on Clinical Outcomes of Patients Undergoing Coronary Revascularization</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2007</date><risdate>2007</risdate><volume>71</volume><issue>8</issue><spage>1299</spage><epage>1304</epage><pages>1299-1304</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><abstract>Background Patients with renal insufficiency are more likely to die after coronary revascularization, but mild renal insufficiency is neglected and little is known about its clinical effects. Methods and Results In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) were analyzed to evaluate the association between CrCl and clinical outcome. The mean serum creatinine was 1.0±0.4 mg/dl, with 4.3% above normal; in 65.8% CrCl was <90 ml/min. During hospitalization, there were significant differences in mortality among the groups stratified by CrCl (p<0.0001). During follow-up after hospital discharge, there were significant differences in mortality (p<0.0001), new-onset myocardial infarction (p=0.007), and stroke (p=0.032). In patients with severe renal insufficiency, the in-hospital and follow-up mortality reached 15.4% and 31.3%, respectively. The independent risk factors for all-cause death after revascularization were the mode of revascularization, age and the CrCl level. In patients with mild renal insufficiency or normal renal function, the all-cause mortality after percutaneous coronary intervention was significantly lower than that after CABG. Conclusions Renal insufficiency is not rare in patients undergoing coronary revascularization and in the present study even mild renal insufficiency correlated with adverse clinical outcomes after revascularization. In patients with normal renal function or mild renal insufficiency, the mode of revascularization might lead to a prognostic difference. (Circ J 2007; 71: 1299 - 1304)</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>17652899</pmid><doi>10.1253/circj.71.1299</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation Journal, 2007, Vol.71(8), pp.1299-1304 |
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| source | Medical Journals (Open access) |
| subjects | Adult Aged Chronic kidney disease Creatine Creatinine clearance End-stage renal disease Female Hospital Mortality Humans Male Middle Aged Mortality Myocardial Infarction - etiology Myocardial Revascularization - adverse effects Myocardial Revascularization - mortality Prevalence Prognosis Renal Insufficiency - complications Renal Insufficiency - mortality Revascularization Stroke - etiology Treatment Outcome |
| title | Prevalence and Impact of Renal Insufficiency on Clinical Outcomes of Patients Undergoing Coronary Revascularization |
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